When opioids enter the brain, they bind to receptors known as μ (mu) opioid receptors on brain cells, or neurons. These receptors stimulate the “reward center” of the brain. Over time, those receptors become less sensitive, and more of the drug is needed to stimulate the reward center.

New provisional data released this month by the Centers for Disease Control and Prevention shows that drug overdose deaths declined in 14 states — including Washington state — during the 12-month period that ended July 2017, a potentially hopeful sign that policies aimed at curbing the death toll may be working.

His uncle’s death shook Ostrovsky, a pediatrician appointed to the Centers for Medicare & Medicaid Services in 2016. He had championed better drug treatment programs for the 74 million people on Medicaid — an increasingly uphill battle after Republicans signaled they would trim the program under President Donald Trump.

The LEAD program was launched in Seattle six years ago. Health advocates argued that the only way to break the cycle of repeated petty crimes and arrests was to provide housing and mental health and addiction services to people who needed it most. At that time, it was the police department that was reluctant to sign up.

In the UK, men are more likely to try drugs than women and they significantly outnumber women in accessing treatment, reinforcing the view that male drug use is the norm. But the number of women who use drugs is probably massively underestimated.

Studies have found that these confidential programs have about an 80 percent success rate, far higher than the typical success rate of 50 percent for the general population. Researchers believe its rewards-based strategy and extensive follow-up care could help many more of the roughly 20 million Americans who suffer from opioid and other drug and alcohol addictions.

Why do they do it? This is a question that friends and families often ask of those who are addicted. It’s difficult to explain how drug addiction develops over time. To many, it looks like the constant search for pleasure.

The opioid epidemic is touching a much younger set of victims: children whose parents have substance abuse problems, who are increasingly being shuttled through the foster care system, unable to stay at home even as their parents struggle to get clean.

There are recovery and treatment centers that can help people quit using drugs. But this help can be expensive, and waiting lists for state and city-funded programs are often extremely long. So can detoxing on your own be the solution? In most cases, the answer is no.

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